Provider Demographics
NPI:1861814246
Name:CAMELFORD, KELLIE GIORGIO (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:GIORGIO
Last Name:CAMELFORD
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:KELLIE
Other - Middle Name:LEE
Other - Last Name:GIORGIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6660 RIVERSIDE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-3272
Mailing Address - Country:US
Mailing Address - Phone:504-908-0017
Mailing Address - Fax:
Practice Address - Street 1:6660 RIVERSIDE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-3272
Practice Address - Country:US
Practice Address - Phone:504-908-0017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4701101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional